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  • Case Study
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Focal segmental glomerulosclerosis as a complication of graft-versus-host disease

Nature Reviews Nephrology volume 5, pages 236–240 (2009)Cite this article

Abstract

Background. A 54-year-old man with multiple myeloma underwent peripheral blood stem cell transplantation (PBSCT) with cells donated by his human leukocyte antigen (HLA)-identical sister. Eight months after PBSCT, the patient experienced chronic graft-versus-host disease with skin involvement (generalized erythema), mucosal ulceration, sicca syndrome, and elevated liver enzymes. Two years after PBSCT, the patient developed nephrotic syndrome with massive proteinuria, which required hospitalization.

Investigations. Physical examination, blood and urine analyses, liver function tests, 24 h urinary albumin excretion and renal biopsy.

Diagnosis. Focal segmental glomerulosclerosis as a complication of graft-versus-host disease.

Management. Prednisone, ciclosporin and an angiotensin-converting-enzyme inhibitor.

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Figure 1: Renal biopsy findings by light microscopy.

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Acknowledgements

Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. Renal Unit, Sant'Andrea University Hospital, University of Rome “La Sapienza”, Rome, Italy

    Claudia Fofi, Simona Barberi, Antonella Stoppacciaro, Giorgio Punzo & Paolo Menè

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Correspondence to Claudia Fofi.

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Fofi, C., Barberi, S., Stoppacciaro, A. et al. Focal segmental glomerulosclerosis as a complication of graft-versus-host disease. Nat Rev Nephrol 5, 236–240 (2009). https://doi.org/10.1038/nrneph.2009.11

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